The effects of dopexamine on renal function in surgical renal artery reconstruction: a pilot study

Aims

To evaluate the effects of dopexamine on haemodynamics and renal function in patients undergoing surgical renal artery reconstruction (RARS).

Methods

Ten patients (aged 54 to 75; 7 males), scheduled for RARS were randomised, following cardiovascular optimisation, to receive either dopexamine (1 μg/kg/min), introduced 2 h before surgery and continued for 24 h after surgery (DPX, n = 5), or placebo (PLA, n = 5). Anaesthesia was similar in both groups. Pre-operatively, all patients were assessed by renal angiography. Renal function was assessed by plasma creatinine, creatinine clearance and iohexol clearance [1]. Haemodynamics and splanchnic perfusion were assessed by invasive cardiovascular monitoring and gastric tonometry respectively. Data are expressed as mean ± SD. Statistics: Student's t test was used.

Results

The 2 groups were comparable with reference to demographic data and surgical procedures (POSSUM predicted risks:DPX mortality 21%, morbidity 72%; PLA mortality 22%, morbidity 75%). There was 1 death in each group in the first 8 weeks after surgery. Data was incomplete for iohexol clearance due to technical difficulties (numbers in subscript).There was no significant difference between the groups in iohexol or creatinine clearance (Iox, CreaCl, ml/min), plasma creatinine (Great, μmol/l), urinary volumes (UrVol, l), pHi, oxygen delivery (DO₂I) and consumption (VO₂I, ml/min/m²) and oxygen extraction ratio (%). Results are shown in the table overleaf (*P < 0.1, significance = P < 0.05):

Conclusion

In this small group, dopexamine at this dose did not appear to offer a significant benefit to patients undergoing RARS.

Table